Tearing during labor is a huge fear of many women during pregnancy. We often get questions regarding tearing and how to prepare for a tear in your vagina, perineum and sometimes (unfortunately) beyond.
One thing that many people are concerned about is tearing vs. episiotomy. An episiotomy is a surgical cut made at the perineum to aid in delivery and prevent tearing. Episiotomies are performed in around 1 out of 5 vaginal births. The doctor uses a scalpel to cut the muscle in the perineum and stitches the perineum after the baby is born. This helps the opening of the vagina to be larger so that a baby with a particularly large head or a baby who is positioned differently, will have an easier descent into the world.
Tearing is the natural episiotomy. The baby causes the muscle in your perineum to tear as the baby descends which, again, causes a larger opening for baby to come out. Both tearing and episiotomy need stitches in most instances. If it is a very small tear, some OB's and midwives won't use stitches but these instances are very rare.
This is the thing about tearing, in the moment, you won't even know. The second your baby is born, you are flooded with oxytocin and other feel good hormones! You're baby, the one that you've been waiting at least nine months for, is here! The baby is placed on your chest and your new life as a mother to this beautiful child begins! Its a very powerful moment for many new families and the idea of tearing your perineum probably won't even phase you.
If have given birth naturally, you're OB or midwife will apply a local anesthetic that will numb the muscles in your vulva and perineum. The stitching takes between 5-45 minutes depending on the type of tear or episiotomy. If you have given birth with an epidural that is working correctly, you will be stitched up immediately with no local anesthetic as you're already numb.
Unfortunately, a first time mom has around a 95% chance of tearing, in some way, during childbirth. Some ways that you can combat this are practicing perineal massage before you go into labor.
When recovering from a vaginal tear or episiotomy, it is essential to keep the area flexible. You can do this by using a sitz bath with warm water a few times each day during recovery. Using a peri bottle instead of toilet paper can also help the area heal as you don't want to be doing a lot of wiping and moving around of the tissue. Using "padsicles" are another great way to heal and soothe the area.
If you tear or receive an episiotomy during birth, don't fret. Your body will heal! You're perineum will go back to you're normal and you won't be uncomfortable forever. You've just done an amazing thing! Giving birth is hard on your body, care for it and prepare, but try to remember that we've all (mostly) been there and you are doing great!